AVERA QUEEN OF PEACE (NPI# 1205359031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205359031 |
| Entity Type | Organization |
| Organization Name | AVERA QUEEN OF PEACE |
| Other Organization Name | AMG HOSPITALISTS MITCHELL |
| Practice Address |
525 N Foster St Mitchell SD 57301-2966 |
| Mailing Address |
Po Box 432 Mitchell SD 57301-0432 |
| Practice Telephone | 6059952000 |
| Practice Fax Number | 6059955683 |
| Mailing Telephone | 6059957000 |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2020-08-20 |
| Authorized Official Name | DOUGLAS EKEREN (PRESIDENT/CEO) |
| Authorized Official Telephone | 6056688322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | MEDICARE PIN | S1639 | 01 |
| Other Name | Type Code |
|---|---|
| AMG Hospitalists Mitchell | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568986040 | Avera Queen of Peace | Internal Medicine | 605 N Foster St Ste 100, Mitchell, SD 57301-2902 | 2017-07-27 |
| 1689051682 | Avera Queen of Peace | Clinic/Center | 409 S Ohlman St, Mitchell, SD 57301-3106 | 2015-04-29 |
| 1649577297 | Avera Queen of Peace | Clinic/Center | 1900 Grassland Dr., Mitchell, SD 57301-6205 | 2011-02-17 |
| 1053557967 | Avera Queen of Peace | Physician Assistant | 115 Second St Se, De Smet, SD 57231-0463 | 2008-12-23 |
| 1699972422 | Avera Queen of Peace | Specialist | 625 N Foster St Ste 200, Mitchell, SD 57301-2968 | 2007-06-27 |
| 1992712921 | Avera Queen of Peace | Pharmacy | 609 1st St Ne, Wessington Springs, SD 57382-2136 | 2006-08-02 |
| 1932105046 | Avera Queen of Peace | Clinic/Center | 265 Main Street, Corsica, SD 57328 | 2005-06-23 |
| 1326043092 | Avera Queen of Peace | Clinic/Center | 213 South Main, Howard, SD 57349 | 2005-06-17 |
| 1316942204 | Avera Queen of Peace | Clinic/Center | 604 1st St Ne, Wessington Springs, SD 57382-2134 | 2005-06-16 |
| 1639174568 | Avera Queen of Peace | Clinic/Center | 741 S Hill St, Salem, SD 57058-8761 | 2005-06-16 |
| Street Address |
525 N FOSTER ST |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301-2966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324507 | Avera Queen of Peace | Emergency Medicine | 525 N Foster St, Mitchell, SD 57301-2966 | 2005-05-31 |
| 1831752393 | Avera Queen of Peace | Preventive Medicine | 525 N Foster St, Mitchell, SD 57301-2966 | 2019-04-19 |
| 1609358035 | Rachel Dykstra | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2999 | 2018-09-01 |
| 1598241820 | Sarah Lynne Bauer | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2999 | 2018-07-19 |
| 1053827634 | Avera Queen of Peace | Radiology | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-19 |
| 1821504515 | Mollie Jo Loes | Dietitian, Registered | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-18 |
| 1669987137 | Karen Faye Klinkner | Dietitian, Registered | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-06 |
| 1295240786 | Katherine Caroline Thomsen | Dietitian, Registered | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-06 |
| 1669822946 | Jenna Bortnem | Physical Therapist | 525 N Foster St, Mitchell, SD 57301-2966 | 2016-06-16 |
| 1356799316 | Avera Home Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 525 N Foster St, Mitchell, SD 57301-2966 | 2016-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932721388 | Dakota Counseling Institute | Social Worker | 910 W Havens, Mitchell, SD 57301 | 2020-05-08 |
| 1215588512 | Carolyn Marie Klinkhammer | Registered Nurse | 525 North Foster - Avera Queen of Peace Hospital, Mitchell, SD 57301 | 2019-09-27 |
| 1720596893 | Brian Bannwarth | Pharmacist | 25147 Campground Road, Mitchell, SD 57301 | 2018-01-11 |
| 1336664135 | Haley Long | Speech-Language Pathologist | 200 East Havens, Mitchell, SD 57301 | 2017-08-14 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1467831685 | Amanda Louise Johnson | Physical Therapist | 910 S Edgerton, Mitchell, SD 57301 | 2015-05-20 |
| 1922432830 | Melissa Jill Maier | Dentist | 240 E 23 Ave, Mitchell, SD 57301 | 2013-08-27 |
| 1356626972 | Lewis Family Drug, LLC | Pharmacy | 1507 N Main St, Mitchell, SD 57301 | 2011-10-14 |
| 1184945958 | Kimberly L Lienemann | Counselor | 403 N Lawler St, Mitchell, SD 57301 | 2010-06-16 |
| 1134365554 | Gronsten-maier Dental Prof. LLC | Dentist | 240 E. 23rd Avenue, Mitchell, SD 57301 | 2009-01-07 |
| Find all providers in zip 57301 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760882062 | Avera Queen of Peace | Hospitalist | 525 N Foster St, Mitchell, SD 57301-2966 | 2014-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255750105 | Naji Alhasnawi | Hospitalist | 4520 Wentworth Dr, Rapid City, SD 57702-1956 | 2014-04-08 |
| 1376896621 | Black Hills Surgical Hospital LLP | Hospitalist | 1868 Lombardy Dr, Rapid City, SD 57703-4130 | 2012-10-24 |
| 1043521974 | Kantee Karki | Hospitalist | 353 Fairmont Blvd/, Rapid City, SD 57701 | 2010-06-25 |
| 1104821248 | Raymond W Nowaczyk | Hospitalist | 353 Fairmont Blvd, Rapid City, SD 57701 | 2005-06-16 |
| 1124540232 | Hafez Mohammad Ammar Abdullah | Hospitalist | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2017-07-10 |
| 1679094726 | Andreea-constanta Stan | Hospitalist | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2017-06-29 |
| 1386179570 | Anthony Paul Whitlow | Hospitalist | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2017-04-25 |
| 1902339252 | Iqra Haq | Hospitalist | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 | 2017-04-04 |
| 1588196448 | Ayodeji O. Balogun | Hospitalist | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2017-03-30 |
| 1154718955 | Guy Vin Chang | Hospitalist | 1305 W 18th St, Sioux Falls, SD 57105 | 2015-04-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.